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"The duty of responsible stewardship is very clear, a concept that can be equated to the notions of trust and trusteeship in today’s international legal terminology. The obligation to maintain the highest level of integrity in the management of donated resources, and of the institutions benefiting from them, is grounded in our faith."

His Highness the
Aga Khan, Conference on Indigenous Philanthropy, Islamabad, Pakistan (21 October 2000)

Health

While maintaining that early focus on maternal and child health, AKHS also offers services that range from primary health care to diagnostic services and curative care.While maintaining that early focus on maternal and child health, AKHS also offers services that range from primary health care to diagnostic services and curative care.The first health institution built in Pakistan was a 42-bed maternity hospital - formerly known as the Janbai Maternity Home - which opened in Karachi in 1924. Today, while maintaining that early focus on maternal and child health, Aga Khan Health Services also offers services that range from primary health care to diagnostic services and curative care. It reaches over 1.1 million people in rural and urban Sindh, Punjab as well as the North West Frontier, Northern Areas and Chitral. As the largest not-for-profit private health care system in Pakistan, its goal is to supplement the Government's efforts in health care provision, especially in the areas of maternal and child health and primary health care. AKHS,P now operates 47 health centres in Karachi, 27 in other parts Sindh, 14 in Punjab and North West Frontier provinces, 33 in the Northern Areas and 31 in Chitral.

In the North of Pakistan, AKHS has been implementing the Northern Pakistan Primary Health Care Programme since 1987. Working in partnership with local communities, the government, and other AKDN institutions, like the Aga Khan Rural Support Programme, the goal has been to find sustainable ways of financing and delivering primary health care in the high-mountain valleys. This has led to a village-based approach -- the designation of community health workers by the local village organisation, the training of these workers in community-based disease prevention, and the reorientation of health professionals (government and private) to primary health care. Since it began, AKHS,P has trained over 1000 Community Health Workers and 1000 Traditional Birth Attendants in the Northern Areas and Chitral.

Through this and related programmes, AKHS,P has been working to promote a new orientation of health services in Pakistan towards primary health care. Close collaboration with AKF and AKU has been the cornerstone of this endeavour. The three institutions are also collaborating in a drive to build health systems linking preventive and curative care efforts, as well as the different levels in the AKHS,P system, from the village health centre to the Aga Khan University Hospital in Karachi.

Aga Khan University
Aga Khan University (AKU), founded in 1980, provides higher education for healthcare professionals and develops research pertinent to Pakistan and the developing worlds. Its overall mandate is to promote the welfare of the people of Pakistan and other developing countries.

At the heart of AKU is the 550-bed University Hospital in Karachi, which became the first teaching hospital in Pakistan to be completely ISO 9002 certified. It received IS0 9001 certification in 2003 and the prestigious Joint Commission International Accreditation in 2006. The Hospital is the main teaching site for AKU’s Faculty of Health Sciences, which includes a Medical College and a School of Nursing.

The School of NursingThe School of NursingThe School of Nursing, which began operations in 1980 to address a chronic shortage of nurses driven partly by a low estimation profession’s low estimation at the time, educates nurses to provide exemplary patient care and demonstrate leadership in nursing education, practice, administration and research. The School offers programmes in the General Nursing Diploma (RN), Post RN BScN, BScN and MScN - the first of its kind in Pakistan. It has since expanded its programmes to Kenya, Uganda and Tanzania and provides technical assistance and capacity building for nursing education and services in Afghanistan, Syria and Egypt.

The Medical College was established in 1983. Its main objective is to train good doctors and leaders who will go on to raise the quality of care in developing countries through improvements to primary, secondary and tertiary health care systems and research on relevant diseases and through technical assistance to governments at all levels. It enrolls students in a five-year programme leading to a Bachelor of Medicine and Bachelor of Surgery (MBBS) degree. In postgraduate medical education (PGME), the University offers four-year postgraduate residency training programmes in over 40 clinical disciplines. Graduate programmes include Masters of Science degrees in Epidemiology and Biostatistics and in Health Policy and Management, as well as a PhD in Health Sciences - the first of its kind in Pakistan.

Courses offered are meant to build human resources in key areas where those resources have until now been lacking, especially in health care and education; research AKU conducts must be relevant and have an impact on chronic and emerging diseases in developing societies; the models it formulates are meant to be emulated, both formally and informally; and the benchmarks and standards it sets, which are invariably high, are meant to raise the overall standard of health care and education.

Among the programmes which have had significant impact on health in Pakistan is the Community Health Services, which worked with the Governments of Pakistan and Sindh province, as well as NGOs, to cut malnutrition in half in some of the poorest districts of the country. The Tawana programme, which targeted 500,000 girls between five and 12 years of age in 5,000 government primary schools, provided a meal a day to each student.

Its programme to meet the need for reliable laboratory testing (the basis of most diagnoses) led AKU to expand the number of its laboratory collection units to 124 in 54 cities and towns in Pakistan, and to build an expanded facility for its central processing laboratory in Karachi. In 2006, the University processed over 5.5 million laboratory tests. Standards set by the AKU units have made them the reference laboratory for doctors throughout Pakistan.

The Patient Welfare programme, which is dedicated to ensuring that medical care is assured to lower income patients, disbursed over Rs. 425 million (US$ 7 million) in 2005-2006. Since the inception of the programme, Rs 1.8 billion (over US$ 30 million) has been given to needy patients. Nearly 74 per cent of all patients treated at the University Hospital in Karachi are from low-to-middle-income groups.

AKU’s faculty are also intimately involved in the nursing and teacher education programmes Kenya, Tanzania and Uganda, as well as in programmes to improve the health systems in Afghanistan, Syria and Egypt. AKU and has also announced the investment of US$ 700 million in two new campuses in Nairobi, Kenya and Arusha, Tanzania.

For more information, please see the Aga Khan University website.

Health-related Services
The Aga Khan Planning and Building Services (AKPBS) works to improve the built environment, particularly housing design and construction, village planning, natural hazard mitigation, environmental sanitation, water supplies, and other living conditions. AKPBS achieves these goals through the provision of material and technical assistance and construction management services for rural and urban areas.

AKPBS’s Water and Sanitation Extension Programme (WASEP) provides an integrated approach to water and sanitation while the Building and Construction Improvement Programme (BACIP) develops, tests and applies methods, products and technologies that can improve living conditions. Over 60 different interventions have been created, ranging from smoke-free stoves and screened kitchen cabinets for storing food to water heaters and ventilation systems

Launched in 1997, the Water and Sanitation Extension Programme (WASEP) addresses the need for potable water, which many health officials consider one of the most important aspects to health and overall development. Approximately 80 to 85 percent of the population of Northern Areas of Pakistan and Chitral does not have access to potable water and 60 percent of the population collects water from open channels, often requiring a walk of up to three kilometers several times a day. Women and children are mostly responsible for collecting household water, which can be time- and energy-intensive, drawing children away from studies and women form their household chores and external income-raising activities. WASEP was initiated in 1997 with the aim of reducing the risk of water-borne diseases through the provision of potable water as well as improved hygiene and sanitation practices.

WASEP was named the 2005 winner of the US $1 million Alcan Prize for Sustainability by the Prince of Wales International Business Leaders Forum (IBLF). The success of the programme has led to a partnership between AKPBS and the Pakistan Poverty Alleviation Fund. As a result, the programme is being replicated in several other areas in Pakistan with the support of donors and partners

AKPBS’s Building and Construction Improvement Programme (BACIP) addresses the harsh living conditions in the Northern Areas and Chitral, where poverty is reflected in deteriorating housing conditions that have, in turn, resulted in major health-related problems. To address these issues in a comprehensive way, AKPBS set up the BACIP programme, which develops, tests and applies methods, products and technologies that can improve living conditions. Over 70 different interventions have been created, ranging from smoke-free stoves and screened kitchen cabinets for storing food to water heaters and ventilation systems.

In 2006, BACIP received the World Habitat Award for its efforts to improve housing conditions in Pakistan. BACIP has also been listed by the United Nations Development Programme (UNDP)-Global Environmental Facility (GEF)/ Small Grants Programme (SGP) as Best Practice in UNDP/GEF-SGP 10 years of operations in Pakistan. For more information, please see the press release.

Following the catastrophic earthquake in Kashmir and NWFP province of Pakistan, AKPBS provided temporary shelters, water supply and sanitation facilities to affected communities and villages. A comprehensive reconstruction programme encompassing permanent seismic resistant housing, environmental health, community capacity building, and livelihood opportunities is underway.

AKPBS in Pakistan was also named as the 2005 winner of the US $1.0 million Alcan Prize for Sustainability by the Prince of Wales International Business Leaders Forum (IBLF), for promoting sustainable social, economic and environmental development in the country through its efforts to improve the built environment and water and sanitation services.

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